This project will examine predictors of and outcomes after recurrent Clostridium difficile infection in adults. Predictors will include age, sex, diagnoses, severity of illness, hospital length of stay, and antibiotic exposure. Outcomes will include hospital utilization, particularly use of intensive care, mortality, and other major morbidity (e.g., major bowel surgery). The initial cohort will consist of adults 18 years of age or older who (a) were members on 1/1/02, (b) did not have any C difficile infection between 9/1/01 and 12/31/01, and (c) developed C difficile infection on or after 1/1/02. These patients will then be divided into those that did and did not have a recurrent (2nd) C difficile infection.